Why may I require reoperation after 5-8 years?
The prostate continues to grow after middle age and so any operation of this type will only last until the prostate regrows over time. About 1 in 20 men require re-operation within the first year. This is due to some prostates being fibrous or containing calcium deposits, which make the laser less effective.
Is this a treatment for cancer of the prostate?
The Greenlight laser procedure is only used to mechanically remove the obstructing prostate lobes, thereby increasing the urinary flow after operation. This is one disadvantage of the procedure when compared with traditional TURP, as there are no 'prostate chippings' collected that can be sent to look for cancer of the prostate.
What happens to the lining of the urethra during the Greenlight procedure?
The part of the urethral tube which passes through the middle of the prostate is destroyed during the laser vaporisation procedure. By the three month stage, the new larger cavity becomes relined with the body's natural cells leaving a smooth surface.
What can I expect after the Greenlight procedure?
There will be a period of increased irritative symptoms including urinary frequency, urgency and getting up at night. This can last up to 4-5 weeks or occasionally longer as part of the recovery process. You may also pass some blood during urination, especially if you have strained the pelvic floor in the first few weeks. These are all common symptoms after the operation and will soon settle.
Will there be any effects on my sex life?
25% of men experience retrograde ejaculation resulting in a 'dry' orgasm. The figure for TURP remains around 90%. If it occurs, it is unlikely that you could father children, but you cannot rely on this as a method of contraception. Some men report a change in sensation of orgasm. There are no reports of erection problems with the Greenlight procedure.
When will I notice an improvement in my symptoms?
You will probably notice a good improvement in urinary flow almost straight away after the catheter has been removed. Some 7% of men experience mild discomfort of the urethra (waterpipe) immediately after the operation. In the following weeks, you may experience moderate frequency and urgency of urination. It sometimes feels as though you have a urine infection in it's severity as the nerves under the prostate have been temporarily affected by the heating effect of the laser fibre action. You will be advised to drink plenty of water whilst avoiding caffeine and spicy foods during this time until these symptoms settle.
Are there any complications to be expected?
As with any operation, other surgical complications can occur. These include infections, heart problems or deep vein thrombosis (blood clots in the legs). The risks of these are small and will be discussed with you at the pre-assessment visit prior to the operation.
What happens if I have a catheter in place before the procedure?
The catheter is usually removed the day after surgery and you may go home the same day. If you have had a catheter prior to operation, the new catheter after laser prostatectomy may have to remain for a few more days in order to allow any swelling to settle. You will usually be given a 'flip-flow' valve to exercise the bladder before it is removed in these cases.
What happens to my prostate medications after the procedure?
Once the procedure has been completed, you shouldn't need to take any medications for your prostate thereafter. Check with your specialist at the time of your operation to make sure.
When can I get back to normal activities?
Strenuous activity (e.g. digging, heavy lifting) should be avoided for 2 weeks following your operation. Driving can be resumed after one week (some car insurances are not valid during the recovery period after an operation and so please check with your individual insurance company). Sports such as golf or cycling may be resumed after two weeks or when you feel fit. Avoid becoming constipated as straining may lead to bleeding from your prostate cavity. Sexual activity may be resumed, as you feel fit. If you do ejaculate, there may be discoloration of the semen for some weeks. This is normal and soon settles.
Will I need any follow up after my operation?
A follow up appointment will be made for you usually 6 weeks after your operation. You will see your Surgeon and Specialist Practitioner Nurse who will ask you to complete a health questionnaire and answer any questions that you may have concerning your operation. You may be asked to provide a urinary flow rate test so come with a full bladder if possible.
How long does the operation last before I need to have it repeated?
The success of this procedure, to date, appears to be similar to the traditional transurethral resection of prostate (TURP) lasting from 5-8+ years.